CARE HOME ADULTS 18-65
Harewood Park Leek Road Cheadle Stoke-on-Trent Staffordshire ST10 2EE Lead Inspector
Sue Jordan Unannounced Inspection 9th January 2006 10:20 Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 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.V277291.R01.S.doc Version 5.1 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.V277291.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Harewood Park Address Leek Road Cheadle Stoke-on-Trent Staffordshire ST10 2EE 01538 755574 01538 756942 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 36 Category(ies) of Learning disability (36), Mental disorder, registration, with number excluding learning disability or dementia (36) of places Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Respite Care & Rehabilitation Nursing Day Assessment Places - 2 Date of last inspection 4th July 2005 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.V277291.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This Unannounced Inspection took place over five and a half hours with one inspector. The methodologies used were informal discussions with some of the residents and staff, a tour of the environment, lunch with the service users, scrutiny of three recruitment files, two of the residents’ care records, policies and procedures and the Health and Safety file. Discussions were held with the management team. The two recommendations made as a result of the last inspection on 12/07/05 have been actioned and no further requirements or recommendations have been made during this visit. This report should be read in conjunction with that from the last inspection. What the service does well:
Harewood Park provides individualised care dependent on service user needs. This is determined prior to admission and care plans and assessments developed accordingly. These are regularly reviewed and the residents are involved in this process. Where appropriate service users are enabled to progress and move out of The Home. The Home is able to provide support to those persons requiring rehabilitation and to those requiring additional assistance. There is facility to offer some of the residents a longer term home. Staff work in designated areas and as a result have specific responsibilities. The residents are encouraged to be as independent as their abilities and/or mental health allows and many take advantage of local community facilities. Where necessary, risk assessments are undertaken to support these activities. The management team are pro-active and welcome positive change. They regularly review the service to assure its quality and standard. Recruitment procedures are robust, new staff receive thorough induction and subsequent comprehensive training, supervision and support. Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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 Park DS0000026951.V277291.R01.S.doc Version 5.1 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 Park DS0000026951.V277291.R01.S.doc Version 5.1 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): 2, 3, 4, 5 Potential service users and/or their representatives are provided with comprehensive information in order that they can make an informed choice as to whether Harewood Park can meet their needs. EVIDENCE: The care records of a recent admission indicate that the management team receive comprehensive information regarding the service users’ needs prior to accepting a referral. Presently there are two vacancies, however the manager stated that admissions are selected carefully to ensure that they can benefit from the service provided. The service users receive a carefully planned service, including rehabilitation strategies and access to professional mental health management. Qualified mental health nurses are available at all times and the care workers undertake applicable NVQ awards. The manager ensures that all employees receive mandatory training covering the Health and Safety aspects. Where appropriate service users are supported to move from the Home to live independently. Support is given by the Home, Care Management and Mental Health professionals. The manager reported that the most recent admission visited the Home prior to admission.
Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 Page 9 A recommendation was made at the last inspection that the service users be better informed as to what is and what is not included in the fees. This information has been developed into contracts between the Home and the residents. Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 Page 10 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, 7, 8, 9 The residents are encouraged to be involved in planning their care and rehabilitation. They are enabled to be as independent as possible. EVIDENCE: Individual and comprehensive care plans are developed for all of the service users. This information is evaluated and reviewed monthly and amendments made accordingly. It is intended that the annual chart of scoring should show service user development. The care plans link to risk assessments, where applicable. The emphasis of Harewood Park is on rehabilitation and independence, although the Home also provides a service for a group of people requiring a longer-term facility, which includes more personal care support. Some of the residents said that they regularly went into the local town, Cheadle. This is supported in their care plans and risk assessments. Discussions with some of the service users confirmed that House meetings are still held weekly and that they are offered one-to-one support. The residents are involved in their review process. Under the Home’s ‘Agenda for Change’, the qualified nurses are now responsible for a group of residents and a team of staff. This involves a key worker role. Harewood Park encourages an ‘open’ culture and the interaction between the residents and the support workers was observed to be positive and respectful.
Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 Page 11 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, 13, 14, 15, 17 The residents are encouraged to lead active and independent life styles, dependent on the needs identified within their care plans and risk assessments. EVIDENCE: This visit confirmed that Harewood Park continues to provide opportunities for rehabilitation and life-skill development. Where possible the service users access local community services, supported by risk assessments, where appropriate. One of the residents confirmed that his family visits him at Harewood Park. Some of the activities arranged last year include; trips to Trentham, Shugborough and Gladstone Hall, arts and crafts and sports. The residents spoken to said that they had enjoyed Christmas and that the Home had “made it as nice as possible”. Some residents went to a pantomime, Christmas
Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 Page 12 lunches and discos and parties were arranged in the Home. One of the resident said that they had all received a Christmas gift from Harewood Park. Two of the residents said that they are planning bike rides as a way of keeping fit. Three of the service users are attending a fitness and health course, via their general practitioner and some have attended the local Cheadle College making Christmas cards and decorations. One of the qualified staff is responsible for the facilitation of activities, which has included accessing college resources. For some residents their rehabilitation programme includes meal preparation. During this visit, one of the residents was preparing bacon and egg supported by a rehabilitation aide. The Home continues to offer a high quality choice of food. The residents spoken to confirmed that they enjoyed the food provided. The Environmental Health Department visited the Home on 23/11/05. Two requirements were made, which as yet have not been actioned. Timescales were not placed on the requirements, however there are plans to improve the kitchen area in 2006. Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 Page 13 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): 18, 19 Personal and Healthcare support is provided according to the needs identified in the individual service user plans. EVIDENCE: Personal care support is defined within the individual care plans. Where possible the service users are encouraged to be self-managing, however the Home provides facility for some residents requiring long-term care and support. The care records contain evidence that the service users are enabled to access the services of medical health professionals providing physical and emotional health support. Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 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): 23 Protection of the service users will be further enhanced by the manager’s attendance at the Local Authority Protection of Vulnerable Adults training. EVIDENCE: Following a previous Commission for Social Care Inspection recommendation, the manager intends to attend Protection of Vulnerable Adults training from the Local Authority on 17/01/06. This information will then be cascaded to the staff team. The recruitment records for three new members of staff contained evidence of Protection of Vulnerable Adults and Criminal Records Bureau checks prior to commencement of employment. All files seen also included two references and the appropriate documentation. Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 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): 24 The Home continues to make improvements to the surroundings, providing the residents with a safe and comfortable environment. EVIDENCE: There have been continued improvements to the environment. Two bedrooms in the annex area have been completely re-furbished and work on three new bedrooms and adjacent shower and wc facilities on the top floor is now finished. The management team wish to extend the Home and have submitted plans for improved kitchen, laundry and office facilities. Unfortunately up to date submission of the plans has been unsuccessful; therefore meanwhile there are plans to continue improving and enhancing the interior of the existing environment. There are plans to re-decorate the main lounge. Risk assessments are carried out throughout the Home, ensuring safety and fire protection systems are robust. Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 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): 31, 32, 34, 35, 36 The competency of staff is assessed and promoted through supervision and regular training, ensuring that the service users benefit from able and motivated support. EVIDENCE: The Home has recently undergone an ‘Agenda for Change’. Three of the qualified nursing staff are now responsible for a group of residents and a team of staff. They are responsible for maintaining, reviewing and amending the care plans and assessments and mentoring designated staff. Prior to the changes, competency assessments were carried out on all care staff. These were dependent on the expected role and included value based principles. Plans are being made to recruit a specialist nurse. Six care staff have achieved the NVQ 2 award, one has nearly completed it and two new staff are being registered. Four care staff have achieved NVQ 3 and three are undertaking it. There are three NVQ Assessors employed in The Home and another member of staff is working towards the award. The manager’s training matrix indicates that food and hygiene training is out of date. The Home’s chef is going to attend a food and hygiene trainer’s training course in February 2006. Training will then be provided ‘in-house’. Harewood
Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 Page 17 Park achieved the Investors in People award in 2005 and as a result the manager was able to attend a computer course. The management team attended training on recruitment and selection, dealing with difficult staff and employment law. The three most recent staff have undertaken a comprehensive induction. The recruitment records for three new members of staff contained evidence of Protection of Vulnerable Adults and Criminal Records Bureau checks prior to commencement of employment. All files seen also included the required documentation. Discussions with a member of staff confirmed that staff continue to receive constructive supervision, which includes aims and objectives. Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 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): 40, 41, 42 The records within The Home are well maintained, regularly reviewed and updated, providing staff and service users with support, guidance and protection. EVIDENCE: The manager recently reviewed The Home’s policies and procedures. She also intends to introduce a system by which staff sign their understanding and agreement. Key policies and procedures are covered in the staff induction programme. The records within The Home are well maintained, regularly reviewed and updated, providing staff and service users with support, guidance and protection. The manager monitors the records as part of a quarterly quality audit. A random selection of the Health and Safety records were seen. The procedures in place ensure the protection of the residents and staff.
Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 Page 19 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 X 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 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 3 32 3 33 X 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 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X X 3 3 3 x Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Harewood Park DS0000026951.V277291.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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