Inspection on 27/10/06 for Harewood Park

This inspection was carried out on 27th October 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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harewood Park 27/05/08

Harewood Park 09/01/06

Harewood Park 04/07/05

Harewood Park 08/02/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Harewood Park Leek Road Cheadle Stoke-on-Trent Staffordshire ST10 2EE Lead Inspector Peter Dawson Key Unannounced Inspection 27 October 2006 09:00 Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 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 Park DS0000026951.V312808.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 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 Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harewood Park Address Leek Road Cheadle Stoke-on-Trent Staffordshire ST10 2EE 01538 756942 F/P 01538 756568 moorlands@harewoodpark.wanadoo.co.uk 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) Moorlands Rehabilitation (Staffs) Limited Kathleen Chester Care Home 37 Category(ies) of Learning disability (37), Mental disorder, registration, with number excluding learning disability or dementia (37) of places Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Respite Care & Rehabilitation Nursing Day Assessment Places - 2 Date of last inspection 9th January 2006 Brief Description of the Service: Harewood Park was initially registered in 1986 and is currently registered to provide nursing care for 36 service users, male and female, from the age of 18 years to 55 years who have a past or present mental illness/learning disability. The establishment offers rehabilitation and support and also an individual assessment service. Although the Homes main emphasis is on rehabilitation, individual assessments have identified that some service users may never live independently and as a result the Home is also registered to accommodate some services users over the age of 65 years. Harewood Park is situated in a semi rural location in Cheadle, Stoke on Trent, and is close to all local amenities. The home is set back from the main road and is accessed via a long driveway. There is parking space available to the side of the property. Accommodation is provided to two floors. All bedrooms are single occupancy and six have an en-suite facility. The home has two bathrooms, four shower rooms and eight toilets sited throughout the home. There are four lounges and a separate designated smoking area. The home has a central kitchen but there is also a well-equipped training kitchen for service users to use as part of their rehabilitation programme. There is a laundry facility for main laundry services as well as a small domestic laundry for service users to use. The cottage facility offers semi-independent rehabilitation provision for seven service users and allows for a stepping stone to future independent community living. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector over a period of 8 hours. The inspector had not previously visited the home. A pre-inspection questionnaire had been returned to the Commission prior to the inspection and forms part of information in this report. Most residents were seen and around 14 spoken to directly. Staff on duty were all spoken to were open and helpful and showed enthusiasm about their work and pride in Harewood Park. The two proprietors were seen and spoken to and the Registered Manager involved throughout the inspection. There was an inspection of the whole of the communal areas and samples of bedrooms seen upon invitation from residents. Residents were keen to be involved in the inspection process and also showed pride and “ownership” in presenting their bedrooms and talking about Harewood Park. There was a very positive feel from both residents and staff. No visitors were seen during the inspection. Written feedback directly to the Commission was received from 6 residents. There were very positive comments about the care and life at Harewood Park. One resident said “you cant do what you want in the day”. The person was seen and indicated he was involved in several projects externally and involved in activities and social occasions within the home. He was able to visit the town whenever he wished to, transport was provided and he had not complaints. Other comments included “The staff are great” and “ I am very happy here, it is homely and enjoyable”. Written feedback was received from the visiting GP (retained service) who made positive comments about cooperation with staff, specialist advice being followed and he was satisfied with the overall care provided at Harewood Park. Similarly a Specialist Psychiatric Registrar was also highly satisfied with joint working and the care provided. The home provides care to 30 people in the main building and 7 people in the adapted Cottages in the grounds. All have been involved in rehabilitation programmes. A nucleus of 10 people remain unable to live more independently in the community. The remainder are all involved in rehabilitation programmes of varying intensity. The 7 people in the cottages have (and expressed) early prospects of living in the community, and supported in an intense skill enhancement programme which is evaluated daily with the particular resident. Activities internally and externally are the main objectives for this group of younger adults together with social, medical, emotional and therapeutic support from staff and other professionals. There was a very positive feel about the home. The atmosphere was quite relaxed and residents clearly able to state openly their views about the home Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 6 The Management structure ensures a positive and supportive atmosphere to both residents and staff. There were no requirements arising from the last report. Areas requiring attention following this inspection include: improved recording of some aspects of medication, risk assessments to be completed upon admission and some redecoration of the kitchen area. What the service does well: What has improved since the last inspection? No requirements or recommendations were made at the last inspection. The clinical room has been moved and extended. Air conditioning has been installed. Storage space has been created for staff use improving facilities The laundry has been relocated to a portakabin at the rear of the property to create additional space. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 7 The redecoration programme is ongoing. Since the last inspection the main large lounge area has been tastefully redecorated, including the intricate multicolour plasterwork on the frieze and ceiling. What they could do better: The ceiling area in the kitchen needs redecoration. areas is good. The decoration in all other A count of medication will allow precise auditing of the system. Clarification of precise prescription for Zopiclone must be sought. Risk assessments must be provided for all residents from the point of admission. Ensure all care plans are signed by residents. Consider provision of drinks facilities for residents to promote choice and independence. 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 Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 8 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 Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1- 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There was adequate information to inform about choice of home. Preadmission assessments and visits and also review of placements are in place. EVIDENCE: There is a statement of purpose/service users guide available in the home for present and prospective residents. These documents were seen to cover all aspects of the current service provided. Contracts were not seen but have been amended to include what is, or is not included in the fees. Pre-admission procedures are clear. All residents are invited to visit the home prior to admission. This is the usual procedure and will include overnight stay if possible. There is category approval to provide 2 places for day assessment. A person presently attending on this basis said that he wanted a residential placement as soon as possible, he liked the home, staff, setting and “could not wait to stay permanently”. Pre-admission assessments are vital to appropriate placement (potential residents must benefit from the homes rehabilitation Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 10 programme). Day assessments obviously provide this but all requests for admission where possible, must be in writing from a relevant agency outlining the needs of the person. Home staff additionally carry out their own assessment. The statement of purpose clearly states the service and level of care provided. Staff have the necessary training and experience to deliver that service. There is a registered nurse on duty at all times and a range of other care staff to support the rehabilitation programme and closely monitor and review the progress made in the rehabilitation process. In relation to a recent admission documents showed pre-admission visits had taken place. There was extensive information provided from the previous hospital setting outlining a social history and assessment of need. This had been transposed to the care plan established by the home. A review of the trial placement was reported to have been carried out with the placing authority and other professionals. A written copy of the review was not available but awaited from the placing authority. The person is visited weekly by family and was on the first period of leave at home with parents for one week, at the time of this inspection. The present status of this person under the Mental Health Act 1983 was not clear but clarified during the inspection by the Manager. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6 – 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are good, residents changing needs and goals are known recorded and acted upon. EVIDENCE: A sample of care plans were seen. In relation to a resident admitted 10 weeks previously a good care plan was in place. This was based upon very comprehensive information provided from the previous placement and the homes own assessment. This covered all aspects of personal care, social support and health care. There was a clear strategy relating to specialist needs with planned interventions relating to therapeutic needs as part of the rehabilitation programme. There were no restrictions upon freedom in the plan but positive instructions were clear to staff in dealing with the fact that the person was unable to manage choice. The care instructions were clear and appropriate. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 12 There was no risk assessment relating to the recently admitted resident and this is required. This must include aspects of daily living including going out unescorted, potential self-harm etc. There are 2 daily entries in all care plan records for each resident, covered by the changing staff shifts. Entries were relevant and satisfactory. Some entries in daily notes should be incorporated in reviews/care plans. In an instance seen a resident showed interest in theatre and ballet and wanted help with literacy. It is accepted that these matters may be recorded in the awaited written review Care planning information is reviewed monthly additionally there are statutory reviews including 117 Aftercare, Guardianship, Section 37 carried out as required. Rehabilitation records show ongoing scoring of achievement and skills, with resident involvement ensuring all are aware of progress or areas for further concentration. All know that information is kept confidential and subject to Data Protection. Residents seen confirmed that their choices and aspirations were known and they were supported in reaching goals with support from staff. All are given considerable support in accessing community facilities and visiting relatives/friends wherever possible. Many residents are not local but visit family in areas such as Cheshire, Kent, Merseyside etc. The promotion of social and life skills are part of that process and based upon balanced risk with the need to progress in those areas. Participation in daily life within the home is part of skills enhancement. It was surprising that drinks were served to residents throughout the day and they were unable to prepare hot/cold drinks themselves upon demand. The home will look at providing a safe facility for this purpose. There is in fact a training kitchen which is used as part of the rehabilitation process but under direct staff supervision. Arrangements in “The Cottages” for 7 people are different, residents are engaged in preparation of meals/snacks/drinks etc. House meetings are held weekly allowing direct input into the daily routines of the home. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11 - 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Community involvement is central to the homes philosophy with involvement of relatives. Residents rights and choices are also an integral part of that philosophy. EVIDENCE: Some aspects of personal development are outlined above. An Activities Organiser provides a lead on activities both inside and outside the home working 22 hours per week in that capacity. Activities are recorded for all residents. There are the usual in-house activities/occupations. Many residents spent the morning of the inspection involved in creative craft-type activities which were discussed and they spoke with enthusiasm about the Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 14 activities provided. There are varying levels of concentration and skill and activities are tailored to those needs. Many residents have significant mental health needs which affect functioning but staff are aware and trained to monitor progress and respond to changing levels of motivation and abilities. Transport is readily available from the home. The local town (Cheadle) is1-2 miles away and there is a local shop a few minutes walk from the home which many residents visit. All facilities- social, recreational, educational and health based are accessed in the community. This is an integral part of rehabilitation/social development programme. Residents confirm that visitors are received in a warm and welcoming way. Access to bedrooms for visitors us at resident choice. Many visit relatives/friends in the community as stated previously and all facilities and support required is offered to achieve that objective. An example of continuity of contact was a resident whose husband lives in Liverpool and each makes regular weekly visits to the other with support from the home and local social workers visits as required. There is a rotating food menu (samples seen) providing varied choices. Residents have an input into menu planning and the cook stated that alternatives to the menu were available if required. The mid day meal was seen served in the dining area and the conservatory. Tables were for four people and were Formica topped, there were no tablecloths and maybe the home should consider more enhancement to provide a more domestic presentation. The main meal is in the evening and staff said that serving dishes were in use to promote individual choice. Residents use local colleges at Cheadle and Leek for access to various courses. This includes pottery, literacy, numeracy and drama. Five residents currently use those facilities. Additionally 4 residents are involved in a gardening project at Brough Park, photographs clearly evidence their involvement/enjoyment. Residents spoke in detail about this project. Another resident is involved on a voluntary basis with the local charity shop. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 – 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal & Health Care Support is provided and well documented. Some aspects of medication provision require action. EVIDENCE: Nursing care is provided in the home throughout the 24 hour period. Nurses are either mental health or learning disability trained. There are no RGN’s. The physical dependency levels are generally low, although some residents who have been resident for some years and unable to take advantage of moves to more independent living are presently being reviewed to ensure needs can continue to be met. There is a small group of 10 people who require some personal support. This is provided to them by Practical Care Aides. The remainder of the group are supported by Therapeutic Aides involved in rehabilitation programmes, cognitive therapy, anxiety management and relaxation Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 16 Health care needs are recorded in care plans. All residents registered with GP surgery in Cheadle. The home have a retained service provided on contract with the GP who visits the home each week. Some residents visit the surgery as required. The GP in written feedback to the Commission expressed satisfaction with the care provided at Harewood Park. He saw residents in private on visits, senior staff were always available for discussion and specialist advice recorded in care plans and acted upon. Many residents have needs relating to enduring mental health needs. All have allocated Consultant Psychiatrist, Key Worker/Social Worker and subject to regular CCA review. Many have Consultants from their area of origin still involved e.g. Tameside, Salop, Bromley, Macclesfield. A Specialist Registrar also provided feedback directly to the Commission and similarly expressed satisfaction with the care provided at Harewood Park and the understanding and co-operation of staff. Two residents self-inject insulin overseen/monitored by the District Nursing Service that also provides oversight of Catheter Care. There are reported to be regular annual health checks for all residents. Medication is provided on a bottle to person basis by local pharmacy. All medication records were inspected. Fridge/room temperatures had not been recorded regularly and this should be done. Only nurses administer medication, one had not given a specimen signature on the signatures list. Zopiclone it was prescribed PRN on the MAR sheet but not the medication label in one instances seen. This must be checked and all entries on MAR sheets must mirror the instructions on the prescribed medication. There was no count of this medication which made it impossible to audit its use. A count of medication should be provided to complete the medication audit trail. There were protocols in place for all PRN medication seen. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are clear instructions for reporting complaints and measures in place to protect residents. EVIDENCE: There is a clear, concise complaints procedure posted in the home for residents and visitors. Additionally a copy is provided with the Service Users Guide to all residents. Several residents in written feedback had stated that they did not know how to make a complaint. There are certainly adequate procedures available in the home and maybe this could be re-enforced in residents meetings. There have been no complaints to the home or the Commission since the last inspection. Following a previous recommendation the Manager attended a Protection of Vulnerable Adults Course on 17/01/06 and has cascaded the information to all staff. The Manager also felt that coverage of Vulnerable Adults issues in NVQ training was a further opportunity for training. Staff files indicated appropriate checks of POVA/CRB prior to employment. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 18 Three residents are reported to present some challenging behaviours but these are dealt with by diversionary tactics and staff have had some training in understanding the aggressive behaviours of some residents. Physical restraint is not appropriate and not used in this home Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 – 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This is a good standard environment, well maintained with ongoing improvements. EVIDENCE: There have been recorded continued improvements to the home. Buildings in the grounds of the home (known as “The Cottages” ) were converted 2 years ago to provide good standard accommodation for 7 residents all with single bedrooms and en-suite facilities including showers. There are also lounge, dining, bathing, laundry and office facilities in this unit. Residents are involved in daily domestic activity as part of skill enhancement. Buy food at local stores and cook meals etc. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 20 In the main building there are 30 single bedrooms, 2 lounges, activities room, dining room, conservatory and office accommodation . There are 2 bathrooms, 4 shower rooms, and 8 toilets located strategically throughout the building. Plans submitted to the Local Authority to further extend the home were turned down last year and continued alternative improvements have been made. The clinical room has been moved, extended and has air conditioning improving storage and space. Storage facilities for staff items and other storage have been created. The laundry has been re-located into a porto cabin building at the rear of the home. A very large proportion of the residents in this home smoke. A good facility has been provided at the rear of the building resembling a “bubble” where residents can smoke as they wish throughout the day with some protection from the weather. There is adequate seating in this area and also on the patio area off the conservatory. There are views across the surrounding countryside. This provides a pleasant and peaceful location which residents clearly enjoy, particularly in the summer months. The ongoing programme of decoration was demonstrated in redecoration of the large main lounge area which retains considerable character and compliments the ornamental intricate ceiling and frieze. There are views of the driveway and countryside from this room presenting a Country House feel to the home. A visiting upholsterer was seen providing a quotation for reupholstery in the lounge and other areas at the time of this unannounced inspection. A sample of bedrooms were seen with permission from residents. In fact there was competition to “show” bedrooms in both the main and Cottage buildings. This evidenced the pride and ownership of the home by residents. All bedrooms have TV points. Examples were seen of mobile telephones, gamesstations, TV, music facilities etc. The only area of the building needing required swift redecoration was the kitchen area. This was a recommendation of the Environmental Health Officer on a visit earlier in the year and was evident on this visit, during an inspection of the kitchen. Paint is peeling off areas surrounding the ceiling in the food storage area and kitchen should be redecorated. The garden, patio and external areas are easily accessible from all parts of the building and witness to many stated summertime events with a Halloween party/disco planned the day following the inspection. All areas of the home seen during this inspection were clean and hygienic. Standards are maintained as part of social skill enhancement by residents and supported by domestic hours provided. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 – 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are satisfactory. There is a good programme of staff training and support. Recruitment procedures protect residents. EVIDENCE: The home employs 7 Nurses (RMN/RMNH), 26 care staff 7 anciliary staff. This includes is a Registered (General) Manager and Mental Health Care Coordinator. Additionally the two Registered Providers (Owners) have a daily presence in the home. On the day of inspection (early shift) care staffing was as follows: 1 RMN, 2 Therapeutic Aides, 1 Care Aide and a student nurse on duty. The later shift included the Activities Co-ordinator. A senior member of staff was on duty in the Cottages. Additionally the Registered Manager was on duty and the 2 Registered Providers were working in the home. Catering and domestic staff were also employed. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 22 There are 3 waking night staff including a nurse. Staff were helpful and open during the inspection and very good engagement was observed between staff and residents. The numbers of staff on duty were adequate for the perceived needs of the current resident group. Staffing records showed good recruitment procedures in place. There is ongoing staff training from the point of induction. All statutory training had been completed. 16 of the 26 care staff (excluding nurses) have achieved NVQ2 or above meeting the required minimum target of 50 . Recent training had included training in mental health aspects of: Bi-polar disorder, Korsakoff’s Psychosis, Borderline Personality Disorder and Self Harm. NVQ Assessors are in place and Student Nurse Mentorship provided at the home. Future plans for training include: Food Hygiene, Continuation of NVQ awards, In-house training re. Specific Disorders and qualified nurse perceptorship. The chef attended Food Hygiene trainers training course in February 2006, outlined in the last report. Mangers have attended training on the selection and recruitment of staff and employment law. Staff supervision is in place and aims to provide quarterly supervision and annual appraisal. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37 – 40 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The conduct and management of the home includes positive leadership in the interests of residents and that their health, safety and welfare are promoted. EVIDENCE: The Registered Manager has worked at the home for 5 years, is a registered nurse and has considerable experience in providing care in relevant settings. She does not wish to pursue the NVQ4 in Management. The Registered Manager provides a positive lead in the home and there is an open an inclusive atmosphere for residents and staff. She provides a Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 24 quarterly quality audit of the home including care delivery, records, environment to ensure the required standards are met. The two Owners/Providers has a daily presence in the home and support the Manager and staff. Management appears transparent. Records seen relating to care planning and other care information was of a good professional standard. The only areas requiring attention relate to medication and risk assessments. Fire records were not inspected on this visit. 23 staff currently hold a first aid certificate, adequate to ensure a trained person on duty at all times. Harewood Park DS0000026951.V312808.R01.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 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X 3 2 X Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 4 Standard YA24 YA20 YA20 YA42 Regulation 23(2)(d) 13(2) 13(2) 13(4)(c ) Requirement Redecoration of the kitchen/storage areas required as outlined in the EHO’s report. MAR sheets must mirror the prescribers instructions. Ensure reducing count of medication to complete audit trail. Risk assessments must be provided covering all aspects of daily living. Timescale for action 31/12/06 28/10/06 28/10/06 28/10/06 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 YA6 YA8 Good Practice Recommendations Ensure all care plans are signed by residents. Consider opportunities for residents to provide drinks/snacks as part of their rehabilitation process. Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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. Extracts may not be used or reproduced without the express permission of CSCI Harewood Park DS0000026951.V312808.R01.S.doc Version 5.2 Page 28 - 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. 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