Inspection on 22/11/07 for Harker House

This inspection was carried out on 22nd November 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

Harker House 25/01/07

Harker House 22/11/05

Harker House 13/01/05

Harker House 21/06/04

Harker House 03/02/04

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

CARE HOMES FOR OLDER PEOPLE Harker House Flowerpot Lane Long Stratton Norwich Norfolk NR15 2TS Lead Inspector Mr Pearson Clarke Unannounced Inspection 22nd November 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Harker House DS0000034340.V355463.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. Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harker House Address Flowerpot Lane Long Stratton Norwich Norfolk NR15 2TS 01508 530777 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) www.norfolk.gov.uk Norfolk County Council-Community Care Mrs Dorothy Evelyn Nisbett Care Home 35 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (27) of places Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users who need wheelchairs to assist with independent mobility at the point of admission can only be accommodated in room numbers 7, 24, 39, 86, 99, 111 and 113. At least one person who has received training in dementia awareness is on duty at all times in the unit for Older People who have dementia. One (1) Service User who has dementia and is named in the Commission`s records may be accommodated in the main home. 25th January 2007 2. 3. Date of last inspection Brief Description of the Service: Harker House is a care home providing personal care and accommodation for 28 older people and 7 older people with dementia. It is owned by Norfolk County Council. The home is located in the busy village of Long Stratton, close to the local GP/Health Centre and close to shops, pubs, post office and other amenities. There are 28 single bedrooms on the ground and first floors and communal lounges are available in different areas of the home. There is a large dining room. A separate unit for those people being cared for with dementia has 7 bedrooms with lounge/dining room and bathroom. The home has a passenger lift. There are gardens to the front and side of the property with car parking to the rear. . At the time of this inspection the services maximum fee was £368.72 with each service users fee individually assessed according to individual circumstance. Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the providers ,the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home and this report gives a brief overview of the service and current judgements for each outcome. During the site visit the inspector spent time with service users both in a group and on an individual basis and views expressed have helped shape the judgements made. In addition time was spent observing life in the home and staff on duty were spoken to as was the service manager. A tour of the premises was undertaken and relevant records were inspected. What the service does well: What has improved since the last inspection? There has been much work to improve and rationalise the homes care planning system. A more stable management team has been established resulting in more effective management delivery. Plans for improvement to the environment have been drawn up and work is soon to commence. The manager has established a system of notices on doors to advise when personal care is being given thereby helping to protect privacy and dignity. Harker House DS0000034340.V355463.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Harker House DS0000034340.V355463.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 Harker House DS0000034340.V355463.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is ( good). Prospective users of the home can be confident that their needs and wishes will have been assessed and that they will have the necessary information about the home available to them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector looked at a selection of six residents care records, which included written pre-admission assessments. In addition to this time was taken to discuss the admission process with the manager, in particular in relation to an admission during the last year which eventually led to a placement breakdown. From the above it was possible to see that the service has a generally effective admission process where needs and wishes are appropriately identified prior to moving in and that these are then used as a basis for establishing a plan of care. In the case of the placement breakdown Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 9 lessons have been learned which have been incorporated into the homes approach in this area. The homes service user guide has been amended since last inspected and this continues to be made available to prospective entrants to the home. Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is (good). People using Harker House benefit from good care plans, a sound approach to medication and health, with staff who respect their dignity and privacy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was evident from inspection of care plans during the site visit and information extracted from the homes annual quality assurance assessment that much work has been undertaken to rationalise and improve the homes care planning system. There remains some work to be completed , but the plans seen represented a much better tool for shaping each persons care delivery. These records and discussion with the service management demonstrated that peoples healthcare needs are being met, although it is unfortunate that there remain problems with delivery of healthcare from the local GP practice, which the provider is working hard to resolve. The arrangements for the management of medication were inspected including Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 11 storage, observation of part of a drug round and sample records. In addition the inspector looked at the services own medication audit system and on this basis found the approach to be satisfactory. Residents spoken to felt that they received care which respected their dignity and privacy and the inspector observed the good practice of notices on doors to alert people to the fact that personal care was taking place. Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is ( good). That residents benefit from a relaxed and open home where they can exercise freedom of choice on a daily basis. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents spoken to by the inspector told him that they live in a good home, where the atmosphere is relaxed and they are able to exercise choice and control over their daily lives. People were happy with the food served and the inspector observed lunch being taken in a relaxed atmosphere with staff help available for those who need it. Staff try to provide regular activity and consideration is being given to having designated hours for this. Residents told the inspector they were generally happy with the activity provided and how much they had enjoyed a visit from the brownies the previous day which had been followed by music and dancing. Harker House DS0000034340.V355463.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is ( good). That people benefit from a service where there is a robust approach to complaints and to safeguarding, which helps ensure their overall protection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector spent time looking at the services complaints record and discussing complaints with the registered manager. From this it was apparent that care is taken to record all concerns and complaints and the records show that these are taken seriously and action follows where necessary. The provider has a robust approach to safeguarding with clear adult protection policies and procedures supported by staff training. Staff spoken to expressed the view that they would speak up if they were concerned about poor practice. Harker House DS0000034340.V355463.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is ( adequate ). That residents enjoy a clean and safe home , which will be much improved when planned work is completed This judgement has been made using available evidence including a visit to this service. EVIDENCE: Previous inspection of the home has identified the environment as an area where there is a need for improvement. During the site visit the inspector was able to tour the home, talk to the manager and look at plans for improvement to the homes reception area. Since last inspected there has been redecoration of some areas and replacement carpets, however there is still many areas which would benefit from upgrading. It was therefore encouraging to see that much work has been scheduled for the home over the next couple of years starting with a major redevelopment of the entrance area. In addition Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 15 bathrooms and toilets are to be refurbished where needed, and redecoration is to take place in the homes dementia unit. All areas of the home seen on this occasion were clean and fresh and residents and staff confirmed that this was the normal picture. Harker House DS0000034340.V355463.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is (good). People using the home benefit from staff who are good at their jobs, well trained and available in sufficient numbers to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector spent time observing staff working and was also able to talk to residents, staff and management about staffing arrangements in the home. Employment and training records were looked at as were staffing rotas submitted by the provider. It was clear from feedback on the day that people feel well looked after and the inspector was told that staff were kind and caring and good at their jobs. Staff feel they work well as a team and that they have the training needed to do their jobs. This picture was supported by the inspectors observation and by the records seen. All concerned acknowledged that dependency levels are increasing and that on occasions of staff shortage this can make care delivery problematic. However staff felt that they were able to meet need when fully staffed and it was noted that the home has improved its relief staffing situation since last inspected. The provider has a robust employment process with all necessary checks in place and this was confirmed by inspection of selected staff files on the day. Harker House DS0000034340.V355463.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is (good). The home is effectively managed and operates in the best interests of those living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since last inspected the service has benefited from a much more settled staffing team. Discussion with staff residents and the service manager confirmed a picture of an improving home where much work has gone into improving management performance. Staff told the inspector that their manager was liked and respected and that they received the support and leadership that they needed, The provider has robust systems for the Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 18 management of residents monies and the promotion of effective health and safety. There is an annual quality process based on survey and at the time of this visit relies to the latest survey were being collected. Supervision records were seen and these demonstrated improved performance in this area and work has commenced on annual appraisals for staff. Harker House DS0000034340.V355463.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 3 x 3 x x x 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 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Harker House DS0000034340.V355463.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. 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 Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Harker House DS0000034340.V355463.R01.S.doc Version 5.2 Page 22 - 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. You have been warned!