Inspection on 16/02/07 for Harper House

This inspection was carried out on 16th February 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harper House 21/02/06

Harper House 10/11/05

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

CARE HOME ADULTS 18-65 Harper House Harper House 2 Cathcart Road Stourbridge West Midlands DY8 3YZ Lead Inspector Mr Richard Eaves Unannounced Inspection 16th February 2007 09:30 Harper House DS0000064200.V327451.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 Harper House DS0000064200.V327451.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. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harper House Address Harper House 2 Cathcart Road Stourbridge West Midlands DY8 3YZ 01384 441469 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) Miss Gail Louise Harper Miss Gail Louise Harper Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Harper House is a large detached property, located in a residential area of Stourbridge. It is within close proximity of Stourbridge Ring Road. The location enables residents to access local amenities and facilities and also neighbouring towns. The home is registered to provide care for a maximum of five younger adults, all of whom have a varying degree of learning disability. There is a small drive to the front of the property and there is parking available on the road. There is a neat garden that is well maintained. The garden has mature shrubs and trees. There is a lounge and dining room on the ground floor. Resident’s bedrooms are all located on the first floor. The home offers two shared and one single occupancy rooms, which do not have en-suite facilities. Fees range from £515 to £1069 per week. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection visit was undertaken by an Inspector from the Commission for Social Care Inspection over one day using the following information: the action plan submitted by the home to the inspections during October 2005 and February 2006, reports from the organisation relating to the conduct of the home, the pre-inspection questionnaire, records held at the home and comment card responses from service users, relatives and visiting professionals. The inspection involved a full tour of the property including, bedrooms, communal rooms and service areas and provided an opportunity to speak with the service users prior to them leaving to go to their planned daily activities. What the service does well: What has improved since the last inspection? Previously identified shortfalls in the assessment process has been addressed such as undertaking nutrition assessment and obtaining dietician guidance, the service users have had an assessment from the continence advisor and organisation of future events such as hospital appointments are improved to prevent missed appointments. Care plans have been developed to provide improved direction to staff. Service user and staff records security has been improved. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 6 Staff training is better organised and records in the form of a matrix more clearly show the progress to completing essential training. The 50 requirement for staff to achieve level 2 NVQ in care is achieved this month with further staff expected to complete during March. Staff have enrolled to undergo learning disability specific training. Quality assurance auditing is well established and informs planning life at the home. The individual contracts for service users have been reviewed and amended to meet the requirements of the standard. In the short period since taking over the home a great deal of progress has been achieved in improving the environment with some ongoing such as retiling the ground floor toilet and further improvements planned when the extension goes ahead which will provide all single en-suite accommodation. 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. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 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 Harper House DS0000064200.V327451.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 – 5. Quality in this outcome area is excellent. Service users and prospective clients are provided with good sources of information about the home and are invited to spend time at the home prior to admission to enable them to make an informed decision about entering the home and receive a contract on admission. The staff group are stable, well established and collectively have the knowledge and skills to assess needs and to meet the assessed needs of the current service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the home has reviewed their Statement of Purpose and service user’s guide. This is available in pictorial format to assist the residents in understanding the contents. The service users guide includes the last inspection report and results of the last surveys, a new survey is currently underway seeking the views of service users and all stakeholders. No new residents have been admitted to the home since the last inspection. A pre-admission policy is available to ensure that the residents’ needs can be met by the home. All identified needs are reviewed on a monthly basis and annual reviews of need are jointly undertaken with Social Services. It is recommended that this process is supplemented with activities of daily living assessment at least twice a year. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 9 Staff have been engaged in an extensive programme of training to ensure staff have the skills and experience to deliver the needs of service users. Training includes National Vocational Qualifications and are enrolled on Learning Disability Award Framework training. The service user contract has been revised since the last inspection and now meets all aspects of the standard. The residents spoken with were pleased with life at the home. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6 – 9 Quality in this outcome area is excellent. Care planning at the home is good, clear and consistent, providing staff with the necessary directions of actions required, to ensure that service users care needs are fully met and health is promoted. Service users are fully involved in all aspects of life at the home and are supported to make decisions for themselves and encouraged to be as independent as possible, even though this may mean taking risks. This judgement has been made using available evidence including a visit to this service. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 11 EVIDENCE: Each of the 5 case files were found to contain care plans that were drawn up to address assessed needs and these were kept under monthly review. The inspector found the language used in the documents to be user friendly with plenty of evidence of service user involvement in all aspects of assessment, care planning and reviews. Monitoring charts derived from the care plan were available as were records of GP and Consultant visits. The case files while being up to date also appear accurate and are kept secure and confidentially maintained. The service users were seen to engage in the day to day running of the home in such activities as shopping, keeping their rooms clean and tidy and clearly gain pleasure and satisfaction from these voluntary inputs. The manager arranges regular service user meetings, minutes of which are taken, topics include outings, holidays and menu’s the last decision of which was to have takeaway meals on Friday evenings and this has been introduced. Surveys of service users and stakeholders views are undertaken yearly and one is currently underway. Service users are individually risk assessed using health and social services protocols and these are kept under regular review. One service user attends a day centre on foot alone, each have risk assessments for journeys into the community by car and for other outings. Other risk assessments include emotional, behaviours, smoking, falls, road safety and community. On the day three went out to day care while the remaining two would be going shopping following lunch. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 12 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): Standards 11 – 17. Quality in this outcome area is good. Staff support service users to access opportunities for their personal development and health promotion. The involvement of family and friends is encouraged in agreement with the service users wishes. The home provides a varied social and recreational activity programme that provides interest and pleasure for service users. Meals at the home are wholesome and meet the nutritional needs of service users while providing for choice and personal taste. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user has opportunities to learn practical life skills with four accessing day centre where skills such as cooking are practiced. The college is used for numeracy and literacy development while one service user has enrolled for computing and woodwork, others participate in arts and crafts. All say they enjoy going to the cinema and shopping. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 13 Service users are identified with their religious background but none currently show an interest in attending services although the local chaplain visits occasionally. Opportunity is provided for service users to vote by post. Each service users have their own interests and hobbies including collecting, music, art, dancing, sport and games, visits to the pub and cinema. Last summer the group enjoyed a holiday in a caravan at Barmouth. All have their own daily routines and these preferences are well documented. The menus have recently been updated and the residents had a meeting to discuss their likes and dislikes. All staff assist with the preparation and cooking of food. Given the residents tend to be out during the day the home have their cooked meal in the evening. All staff have food hygiene certificates. The resident in the home on the day of the visit stated that the food was nice. Drinks and snacks are available throughout the day and night. Fresh fruit and vegetables are available daily. Service users are involved and assist with the shopping at the local shops and supermarkets and undertake such tasks as laying the tables before each meal. The residents’ meetings minutes recorded they were happy with the food. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 14 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): Standards 18 - 20 Quality in this outcome area is good. Service users are assisted to maximise their independence and control over their lives and staff respect their privacy and dignity and give support to achieve this. Healthcare needs are well documented and are compiled with the input of the individual service user. The care plans give clear directions to ensure that service users’ healthcare needs are assessed, recognised and addressed. Arrangements for the administration of medication are good and ensure service users medication needs will be safely met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual plans of care are available, and progress has been made to ensure all aspects of health, personal and social care needs are identified and planned for. Discussions with staff confirmed they were aware of residents’ care needs; and how the care is to be provided. During the inspection it was noted that all service users were achieving good standards of personal hygiene and appearance. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 15 Service users have their physical, emotional and mental health needs met and the care plans evidence general practitioner and other health care professionals input. Medication was well managed. All staff have completed accredited training in medication and regular in-house updates provided. A local chemist provides medications, most in the Nomad monitored dose system and the pharmacist provides advice as required and provides a report of quarterly inspection. Currently no service users are assessed as able to self-administer and control their own medications. The manager confirmed that service users are all subject to regular medical review of their medication regimen. Arrangements for the receipt, storage, administration, recording and disposal of medicines comply with the homes policy and this standard. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 16 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): Standards 22 & 23. Quality in this outcome area is good. The home complaints and protection policies are robust providing a safe environment in which service users feel they can voice concerns and that these will be listened and responded to. Staff demonstrate excellent knowledge and understanding of adult protection issues which contributes to an environment that is safe from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The concerns/complaints policy and procedure has been kept under review and no complaints have been received during the preceding year. The home has policies in keeping with national guidance and staff receive training in adult protection procedures and sign to confirm they have read and understood the policies. The home has a whistle blowing policy. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 17 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): Standards 24 and 30 Quality in this outcome area is excellent The home provides a good standard of décor, furnishings and managed services providing a safe environment, a comfortable, attractive, and homely place in which to live. The home is clean and hygienic and free from odours. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the building including an inspection of the bedrooms that the inspector was invited to see were found to be nicely personalised and included some items of own furniture. The home is in good decorative order and this is undertaken in a programmed way. The level of furnishing is by agreement and a copy of this is kept on the case file. It was observed that approved locks were fitted to the doors and a lockable facility was available in each room. Following a trial the one service user who expressed a wish to hold a key has now returned it. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 18 Safety check records were inspected and show that windows are restricted, radiators are covered, hot water is controlled at close to the standard 43°c, doors are fitted with intumescent strips and cold smoke seals, these require to be monitored to show them to be making a good seal, emergency lighting and fire detection system are tested and in good order. It is recommended that all hot water mixing valves are subject to annual anti scald testing and a record kept. The home was clean and hygienic in all areas. The laundry is equipped with a washing machine with a programme that can meet disinfection standards. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 19 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): Standards 32 – 36. Quality in this outcome area is good. Staff are enthusiastic, sufficient in numbers, well trained, supportive and committed to maximising the service users quality of life. The recruitment practices, staff training and supervision all contribute to ensuring service users benefit from the skills and knowledge of the staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the proprietor has been registered to manage the home. Staffing is now stabilised and the number of staff on duty is a minimum of two throughout the 24-hour day and appears adequate to meet the current needs of service users. A sample of staff files were viewed and show that recruitment procedures are completed to a good standard with appropriate checks of Personal Identification and Criminal Record Bureau in place. Job descriptions appeared satisfactory for roles and support the underlying values of the home. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 20 50 of staff have completed NVQ awards in care with further expected to complete during March. A number of staff have been enrolled to undertake Learning Disability Award Framework training this requires to become a training priority for all staff. A training matrix shows that mandatory training is provided including fire safety and drills, food hygiene, manual handling, first aid, health and safety, Cossh and risk assessing. Induction complies with ‘Skills for Care’ standards. Other training given and planned includes mental health awareness, challenging behaviour, epilepsy, nutrition and accredited medication administration. Staff files contain a record of the supervisions that are undertaken and planned to provide at least 6 meetings each year, topics included are appropriate. Staff meetings are held to allow staff to express their views about the home. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 21 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): Standards 37, 39 & 42. Quality in this outcome area is good. Leadership of this home is good and staff demonstrate an awareness of their roles and responsibilities. The manager’s approach is open and positive and develops positive relationships amongst service users and with staff. The home regularly reviews its performance, which includes seeking the views of service users and their families. The best interests of service users are safeguarded by the homes record keeping, policies and procedures. Environment management and staff training in respect of health and safety ensures service users safety and welfare are protected. This judgement has been made using available evidence including a visit to this service. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager is well qualified holding an NVQ level 4 in care management and has recently updated this by undertaking the Registered Managers Award. The manager is well regarded and liked by the service users and staff alike and this is apparent from the comment cards and in speaking with service users and staff as well as observing the interactions over the day. The manager undertakes a full range of quality audits including an annual survey of service users and other stakeholders views and uses the findings to influence and improve the delivery of care. Since the previous inspection these findings have been written up in report form. A further survey is underway and early responses and the commissions own survey shows a good deal of satisfaction with life at the home. A full range of servicing, maintenance and regular monitoring of services and equipment is undertaken, staff receive training in health and safety and first aid. Records of all accidents are recorded, using data protection compliant documentation and reported as necessary, an audit of all accidents is undertaken on a quarterly basis. Induction and foundation training is provided to Skills for Care requirements. Overall the premises were observed to be managed to meet safety requirements. Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 23 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 4 2 4 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 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 X 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 3 X 3 X 3 X X 3 X Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 24 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. Standard YA35 Regulation Requirement Timescale for action 31/12/07 18(1)(C)(i) The registered person must ensure that staff undertake Learning Disability Award Framework-accredited training. 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. Refer to Standard YA2 Good Practice Recommendations The review of assessments process should include an activities of daily living assessment on a twice-yearly basis or more frequently as changes occur. Hot water mixing valves should be anti-scald tested annually and a record maintained. Monitoring of cold smoke seals should be introduced to ensure they function efficiently and a record maintained. 2. 3. YA29 YA29 Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Harper House DS0000064200.V327451.R01.S.doc Version 5.2 Page 26 - 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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