Inspection on 06/07/07 for Harmony House Care Home

This inspection was carried out on 6th July 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

Harmony House Care Home 01/07/08

Harmony House Care Home 22/05/06

Harmony House Care Home 22/02/06

Harmony House Care Home 29/09/05

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

CARE HOMES FOR OLDER PEOPLE Harmony House Care Home The Bull Ring Chilvers Coton Nuneaton Warwickshire CV10 7BG Lead Inspector Jackie Howe Unannounced Inspection 6th July 2007 09:30 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 Harmony House Care Home DS0000065174.V336577.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. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harmony House Care Home Address The Bull Ring Chilvers Coton Nuneaton Warwickshire CV10 7BG 02476 320532 02476 320632 harmonyhouse@schealthcare.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited 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) vacant post Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (57) of places Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Harmony House may, within its current registration admit up to 5 service users over the age of 60. 22nd May 2006 Date of last inspection Brief Description of the Service: Harmony House is a purpose built care home and is registered to provide residential and nursing care for up to 57 men and women. The home is situated close to junction 3 of the M6, with bus links to Nuneaton town centre and is near by to the George Eliot Hospital. The home is managed by Southern Cross / Ashbourne Ltd. The single room en suite accommodation is situated on two floors. The service provision on the ground floor is for those people who require assistance with personal care. The first floor service provision is for those who require nursing care and qualified nursing staff are available at all times on this unit. Access to the first floor is via passenger lifts/stairs. Garden and patio areas are accessible to all residents including those with limited mobility who require wheelchairs. Information about the home is in a Statement of Purpose and a Service Users Guide is available for all residents. The current scale of charges is £352 - £535 per week. Additional charges are made for chiropody, hairdressing and personal items and sundries such as newspapers. Harmony House Care Home DS0000065174.V336577.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 of the inspection year 2007/08 and was unannounced. It was undertaken over a period of one day, and was carried out between the hours of 09:30 am and 18:00 pm. The inspection focused on the outcome for residents of life in the home. The manager supplied the commission with an Annual Quality Assessment (AQAA) and information from this has been used to make judgements about the service, and been included in this report. The inspection process reviews the home’s ability to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision where improvements may be required. During the inspection, the care of three residents who live in the home was examined in detail. This included reading assessments, care plans and other documentation, observing care offered to them and that staff have the necessary skills to care for them. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for residents. Records including staff files, policies and procedures, health and safety / environmental checks and risk assessments were also read. The manager was present through out the day, and the inspector was able to tour the home, and spend time speaking with residents, relatives and staff. The inspector ate lunch with the residents, and was able to observe care practices, and how staff interacted with residents in the home. The inspector would like to thank the manager, staff and residents for their cooperation and hospitality. What the service does well: It is commendable to note that no requirements were made in respect of this inspection. Good practice recommendations have been made for the manager to continue to make improvement to the service offered. The home provides up to date and relevant information about its services, so that prospective residents and their families can make an informed choice. Residents receive an assessment prior to coming to the home so that the staff can assess the home’s ability to meet the needs of each individual. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 6 Residents speak positively about the home and the staff and are happy with the care and attitude of the staff. ‘The staff are kind and helpful’. ‘If you have any problems you only have to ask’. Complaints are taken seriously, and comments and concerns raised are recorded and dealt with. Residents are protected from potential abuse and their health and welfare is promoted, by robust procedures and good staff training. The home is managed by a team of people who understand the needs of the residents, who ensure that their needs and requirements are listened to and respected and who ensure that the staff are well trained and supervised. What has improved since the last inspection? What they could do better: Care plans should include a more detailed written record of residents’ participation in daily living and social activities and how these are benefiting individuals matched to their needs and aspirations. More information on a resident’s life history would provide staff with more information to show an awareness of a resident’s previous experiences. This information would allow staff to offer a more ‘person centred’ approach to care’. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 7 The results of the quality assurance survey should be presented in a more ‘user friendly’ format and include actions taken as a response to comments made. 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. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 8 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 Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 9 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): Standards 1.2 3 and 6 Quality in this outcome area is good. Information is available for residents and their families to make an informed choice about the home. Prospective residents are assessed so that the home is able to assure them that their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a ‘Statement of Purpose’ and ‘Service Users Guide’ so that prospective residents and their families can receive information about the home, and the services it offers. The manager said that this had been recently reviewed, but the copy seen did not indicate the last date of the review, so that interested parties were not able to see how up to date the document was. It was suggested to the manager that this would be useful to include and she updated the document during the inspection. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 10 The fees payable were also not displayed, which would assist potential residents in making an informed decision; again the Service Users Guide was updated during the inspection. The Home manager has also designed a questions and answers booklet. All new residents to the home are provided with a contract, which sets out the fees payable, and terms and conditions of living in the home. As well as being provided with information about the home, prospective residents are assessed to see that their care and social needs can be met. The preadmission assessment of two residents admitted to the home were read. These pre admission assessments are required to look at a number of key areas of need, including dependency, health and social care needs, including manual handling and specific medical needs as well as potential areas of risk. Where appropriate, the home also seeks information from a care management assessment undertaken by social services, or other health care professionals involved in the care. Assessments read, were completed by the nurse in charge of the residential unit. or the care manager and contained sufficient detail for the home to be able to make a decision as to whether or not needs can be met. Risks assessments were undertaken on key areas of concern. Assessments could be improved to include the residents’ feelings about admission to the home, so that staff are sensitive and aware of individual concerns and anxieties. One family spoken with confirmed that their relative was assessed by the home’s staff, whilst in hospital. Following the assessment someone from the home phoned to confirm that a place was being made available. They said that they came to the home to have a look round and chose Harmony House because they were recommended it and felt it was the most convenient. They confirmed that they felt the home was meeting her needs and that she was ‘doing wonderfully’. They had received a copy of the Statement of Purpose and Service Users Guide and had signed a contract. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9 and 10 Quality in this outcome area is good. Care plans are in place to guide staff in offering personal and health care. Health care available is good. Systems for the safe storage and administration of medication have improved and are robust. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the last inspection year, the home was required to make some improvements to the documenting of care planning, in particular for residents with challenging behaviours, and also in the systems for the management of medication. A number of these had been met by the random inspection undertaken in January 2007 and positive improvements made, although there were still some outstanding requirements particularly around medication. The manager and care manager have continued with the improvements started and all requirements related to medication have been met. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 12 The care plans for three residents were read in detail during the inspection. On admission to the home there are records to show that baseline observations such as blood pressure, weight and pulse are recorded. A ‘service user profile’ is completed and care plans seen showed photographs had been taken and relevant information related to the residents GP, next of kin and date of birth recorded. Information obtained on assessment was expanded and then used to write the care plan. Generally care plan folders were found to be well organised and detailed. Care plans identifying clinical needs were well documented and areas of risk identified, with care plans in place giving staff guidance on how to minimise and monitor risk. One care plan for a resident who was identified as being at risk to falls had a care plan advising staff about correct footwear, removing potential obstacles and levels of observation required. Residents with nutritional risks had had their weight monitored and nutritional screening undertaken. Body maps are in place for staff to record potential pressure areas, or to record wounds, ulcers or sores requiring treatment. Care plans were available showing current treatments. Care plans could be further improved by adopting a more ‘person centred’ approach to care and by addressing the psychological needs of residents further and what staff should do in response. One care plan read for a resident who had been widowed asked staff to ‘observe for changes in mood as this may become low’. There was nothing to show that this had been discussed with the resident, or what actions staff should take in response. Care plans to address social needs are also limited. Information in care plans should be improved to show how an individual’s particular needs for leisure and social activity, is being addressed, and what the home is doing to meet those needs. This was discussed with the manager during the inspection, who agreed that whilst care plans had significantly improved this was an area that still required development and staff awareness. Evidence was available to show that residents are given access to their GP and are supported to attend hospital appointments and receive care from an optician, dentist and a chiropodist. The systems for the safe storage and administration of medication were assessed on both units in the home. Systems in place were found to be robust and the care manager said that she had been auditing practices and asking staff to audit their own performance. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 13 Clinical rooms were found to be in good order and at the correct temperature and a fridge is available to ensure that medications are stored in accordance with their product licence. Medications kept in the fridge were checked, they were within the correct usage date and the date of opening the bottles had been recorded. Proper systems are in place to return unused medication. The records for residents receiving controlled drugs showed that these are administered and stored correctly with the home using a bound CD register. The medications for one resident who had passed away were still in the stock cupboard waiting to be returned, but this was within correct procedural guidelines. Medication Administration Records (MAR) showed that residents are receiving medication as prescribed, and no omissions were noted. Staff spoken with were aware of the different medications and their usage. Training in drug administration has been given. The home has a procedure for ‘homely remedies’ and one resident who was administering his own medication had a risk assessment in place, showing how he was supported in being able to do this. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is excellent. Residents are supported and encouraged in a lifestyle that meets their individual needs, interests and preferences. Residents are able to maintain contact with families and friends, who are welcomed into the home. Residents receive a well balanced diet, with a menu, which is regularly reviewed and offers plenty of choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs an activities organiser for 30 hours per week. There is information displayed around the home about what is available, primarily on an information board in reception. Residents spoken to were very positive about the lifestyle they live and what is available to them. One group of residents spoken with over lunch said: ‘Normally we do things like: Knitting, reading, crosswords, read the newspaper, watching TV. We have a quiz morning on a Wednesday and weekly bingo’. One resident said how much she enjoyed the whist group. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 15 They were also positive about the activities organiser, and her role in the home. ‘Marilyn organises quite a bit for us, she’s very good’. Residents were also aware of the monthly residents’ meetings and said that they had ‘one coming up soon’. One resident said she would like to go to Twycross Zoo. Over lunch, residents were chatting about the afternoons’ boat trip and how much they were looking forward to going. The dining room in the residential unit is being refurbished and residents are currently using one of the lounges on a temporary basis. The Menu on the day of the inspection was: Fish and chips, poached fish, Egg and chips, Rice pudding, yoghurt or ice cream. Dining tables were laid with flowers, tablecloths, napkins and appropriate cutlery. Salt pepper and vinegar were available and tartar sauce and bread and butter were offered separately. There was a choice of orange squash or water to drink. The Meal was served from a hot trolley from a choice made the day before, but choices for the day were confirmed with residents. Three staff were on duty, one was serving the food, and two were serving at the tables. No one in this unit required assistance with eating. Staff were courteous, checking if residents enjoyed their food and offered second helpings. Residents were supplied with appropriate aids to assist with independent eating. Residents described the breakfast available as: Grapefruit, prunes, cereals (choice of many) toast or cooked breakfast such as bacon. Tea was described as something hot, normally on toast (egg beans etc), selection of sandwiches, and supper as a hot drink with biscuits or cheese and biscuits. The head cook was spoken with as part of the inspection. She has recently reviewed the menu and is enthusiastic about the food provision in the home. Special diets such as diabetic and softened diets are provided and the cook liaises with the care manager about diets required. She attends residents meetings to hear about how residents feel about the food and get suggestions. She said that she also spends time going round speaking to the residents about their likes and dislikes and sees all new admissions to the home within the first week of their stay. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 16 The home has started a small garden for some potatoes, peapods, lettuce etc with the idea that residents will be included, by planting some seeds and tasting the items grown. The home also has themed menu days for example St George’s and St Patrick’s day when traditional foods are prepared, Chinese new year when they had pancake rolls and Mothers day when they put roses on the table. Residents spoken with said that they enjoyed the food. Comments received included: ‘The food is very good here- very good’. ‘ There is always enough to eat, you can ask for anything, no one needs to go hungry’. One resident said that she would like to see more sliced meat and green vegetables and had discussed this with the cook. During the inspection it was noted that visitors and relatives were coming and going from the home. They were greeted by staff in a friendly way, and a number approached the manager for a discussion. Relatives spoken with said that they found the staff very helpful and the home a friendly place to visit. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 17 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): Standards 16 and 18 Quality in this outcome area is good. The home had a complaints policy and procedure displayed and people are supported to report complaints and make their comments known. Systems are in place in the home to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The organisation has a complaints procedure, which is displayed around the home, as well as in the information books provided. The procedure is detailed and gives information on how to make a complaint and the timescales for an expected response. Relatives spoken with said that they were aware of how to make a complaint should they wish to do so and would feel comfortable to do this as the manager and the staff were ‘very easy to talk to’. A record of all complaints is maintained by manager, plus a Southern Cross register for the manager to inform the head office of complaints received. The home has received nine complaints since July 2006, some formal some more minor. The home has recorded these on a form that identifies the details of the complaint, the findings following an investigation, actions taken Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 18 as a response and considerations for the improvement in the service if applicable. This is good practice and demonstrates that the home is taking complaints received seriously. The records could be further improved by recording the complainant’s response to the outcomes. The commission has not received any complaints about this service. Training records seen show that Staff have attended training in the Protection of Vulnerable Adults (POVA). A requirement was made at the last inspection to ensure that all staff are aware of how to respond to allegations or suspicions of abuse. The manager and assistant manager have responded by providing an external trainer and doing more in house training on procedures / whistle blowing. The Home has procedures in place and has a copy of the Warwickshire multi agency policy for responding to abuse and the Department of Health ‘No secrets’ documents. Staff recruitment records show that required checks are undertaken and that appropriate responses are made to results of these. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 19 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): Standards 19, 24 and 26 Quality in this outcome area is good. Residents are provided with an environment, which is clean, well maintained, comfortable and suitable to their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was undertaken with the manager. A number of improvements have been made over the past year. Dining rooms are being refurbished and a number of bedrooms have been redecorated and supplied with new curtains and bedding. Residents were included in making choices of the room colours. The entrance hall to the home is warm and welcoming. The front door is protected by a security code. There is a large information board with photographs of staff currently being compiled. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 20 There is also a resident information board displaying information on activities taking place, boat trips, church services, details of residents meetings and copies of previous minutes. Other information available includes a copy of last inspection report, the Statement of Purpose, Service Users Guide, and other booklets are available. On the ground floor, the quiet lounge is currently being used as temporary dining room, the small lounge has a new red carpet and additional ‘homely’ touches such as a display cabinet. There is also a small kitchenette with a microwave for relatives to use. On the top floor there is a hairdressing room, which is used by the hairdresser who visits every Tuesday. There is also a wheel chair storage bay and the corridors are wide and spacious which gives the home an airy and open feel without clutter. The new dining room on the top floor now has a laminated wood floor rather that the original carpet which looks clean and fresh and is easier for staff to clean. There is a new serving bar, space for heated trolleys and a small domestic fridge for juice, milk and ice cream or other items needed for meals. Sluice and cleaning cupboards now have keypad locks to promote safety for residents. In a bathroom a new hoist has been fitted. Both floors also have new clinical rooms, which are kept at the correct temperature to stare medications safely. Personal rooms seen were nicely decorated, clean and contained personal possessions. Relatives confirmed that staff encouraged relatives to bring in personal possessions i.e. pictures, trinkets, own chair, TV etc. The laundry is currently being refurbished. Three new washing machines are waiting to be plumbed in. A tour of the kitchen found it to be well maintained and clean with suitable storage facilities. Cleaning schedules are in place and good basic food hygiene procedures are followed. Outside the home there are both grassed and patio areas, a new summerhouse, chairs and tables, and a recently created raised beds. There are plans for a water feature and gazebo. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 21 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): All the above standards were assessed as part of this inspection. Quality in this outcome area is good. The home ensures that all staff employed are of good character, and recruitment procedures are robust. Training to ensure that staff have the skills to care for the residents is available. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records for two members of staff were read as part of the inspection. Both files showed that appropriate Criminal Record Bureau and POVA first checks had been undertaken and that staff had been appropriately interviewed. Two written references had been obtained and staff had completed application forms giving a work history. By undertaking these processes, the home makes every effort to ensure that only staff suitable to work with vulnerable people, are employed. One member of staff spoken with confirmed that on starting at the home she had received an induction and had spent time with another carer for one week. She said that she had received training in Infection Control, Basic Food Hygiene, Moving and Handling, Protection of Vulnerable Adults and Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 22 demonstrated an understanding of ‘whistle blowing’ procedures. She said that she felt she had received sufficient training to give her the skills to do the job. She confirmed that she has regular staff meetings with her line manager and gets copies of minutes. She currently works as a key worker to four residents, which involves liaising with their families, recording their likes and dislikes and writing into the care plans. The manager has started a training matrix and a training planner is in place. This shows that all identified training requirements had been booked and staff will all be up to date, including all refreshers, by 31/07/07. The manager said and rotas seen show, that agreed staffing levels have been maintained, but recent staff sickness and long term absence has resulted in use of agency staff. The home uses the same agency and is supplied with a consistent staff team. Information is available to state that the agency undertakes CRB checks and training. On the day of the inspection staffing levels appeared suitable to meet the needs of those living in the home. The home employs sufficient support staff to allow carers to undertake their care roles. Throughout the inspection staff were observed to treat residents with courtesy and privacy is respected. Residents spoken with said that they were satisfied with their care, and felt that they were treated respectfully and that they were happy with the care and attitude of the staff. ‘The staff are kind and helpful’. ‘If you have any problems you only have to ask’. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 23 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): Standards 31, 33, 35, 36 and 38. Quality in this outcome area is good. The manager is able to fulfil her responsibilities as manager of the home within an organised management system of policies and procedures. Residents and their families are given opportunities to make their opinions of the service known. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post since November 2006, having previously been employed in the home as the deputy / care manager. She is experienced in this area of care provision being a qualified nurse. She is not yet registered with the commission, but is currently going through the process to do so. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 24 Since starting in this post she has brought about some positive changes to the home and it is commendable to note that requirements made at the last inspection have been met. A new care manager and administrator have also recently been employed, bringing a new management approach to the home. Staff spoken with were positive about the management team and said that they were approachable and they could go to them with any problems. This organisation takes quality assurance seriously, with the home managers undertaking regular audits on the service. A recent survey was undertaken of residents, their relatives and other professionals including Social Workers. 65 surveys were sent out and they received 23 replies. People surveyed were supplied with stamped addressed envelopes so that results were sent direct to head office. People were asked to score the service as: very satisfied, quite satisfied, not very satisfied, and not at all satisfied. An audit was undertaken and results published, but the information is confusing. Results are published in a bar code showing that the majority of people are very satisfied but the document is not user friendly and does not show what actions will be taken in areas where people were not very satisfied. The manager holds a weekly ‘surgery’ and regular resident / relative meetings which are well attended and well advertised in the home. Minutes of these meetings include an update on the actions taken to issues discussed. Residents spoken with aware of these meetings and said that they attended. Systems are in place for the safe keeping of residents’ monies. Records are kept individually and receipts are kept for all expenditures. Staff are now receiving regular supervision from their line manager with the manager supervising the heads of department. Records seen show that the home protects the health and safety of the residents. The home employs a full time maintenance man who undertakes regular portable appliance checks and is responsible for the general up keep of the building and gardens. Fire safety is considered, with staff attending regular training courses and drills, and the home has a fire risk assessment in place. A health and safety audit was undertaken in November 2006. There are no outstanding works fro this inspection and a sensor problem identified with the lift has been rectified. Harmony House Care Home DS0000065174.V336577.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 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 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x 3 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 3 3 x 3 3 x 3 Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 26 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. 1. 2. Refer to Standard OP3 OP7 Good Practice Recommendations Pre admission assessments should be expanded to include an assessment of the particular issues and concerns of prospective residents being admitted to the home. Care plans should include a more detailed written record of residents’ participation in daily living and social activities and how these are benefiting individuals matched to their needs and aspirations. More information on a resident’s life history should be included in the care plan so that staff have an awareness of previous experiences. This information would allow staff to offer a more ‘person centred’ approach to care’. Residents involvement in menu planning and comments made about the food and the responses made to suggestions, should be documented to show how the cook is involving residents in this area of service provision. Records should contain more detail about the complainant’s satisfaction with the results of complaints DS0000065174.V336577.R01.S.doc Version 5.2 Page 27 3. OP7 4. OP15 5. OP16 Harmony House Care Home investigations and the outcomes. 6. OP33 The results of the quality assurance survey should be presented in a more ‘user friendly’ format and include actions taken as a response to comments made. Harmony House Care Home DS0000065174.V336577.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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